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  • New Guy - Had MRI - Next up biopsy

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    Old 01-03-2022, 08:13 PM   #16
    HighlanderCFH
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    Re: New Guy - Had MRI - Next up biopsy

    Here's hoping all you went through results in a clean report. You'll probably get the results this week, I would imagine.

    Good luck!

     
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    Old 01-04-2022, 09:34 AM   #17
    CentralPaDude
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    Re: New Guy - Had MRI - Next up biopsy

    Thanks @Highlander

    All kinds of weird gunk in the urine...blood, clots, and what-not, makes using the loo an adventure full of surprises. But no overnight retention and no fever (so far).

     
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    Old 01-04-2022, 07:53 PM   #18
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    Re: New Guy - Had MRI - Next up biopsy

    Sorry to hear about those side effects. Praying for a good outcome.

     
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    Old 01-05-2022, 04:06 AM   #19
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    Re: New Guy - Had MRI - Next up biopsy

    Did you use testosterone? It can aggravated BPH. It can also produce smaller more aggressive PC which is difficult to find in a much enlarged prostate.

     
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    Old 01-05-2022, 06:25 AM   #20
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    Re: New Guy - Had MRI - Next up biopsy

    I did not. Just a naturally bulky prostate guy, I guess.

    Been dealing with slowly creeping urinary issues for so long that it’s always been normal. Looking forward to maybe seeing at least one benefit out of this whole thing.

    Day 2 following the biopsy. No fever, so looks like I’m not in the 1-3% that have an infection. That was my concern.

     
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    Old 01-05-2022, 09:58 AM   #21
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    Re: New Guy - Had MRI - Next up biopsy

    Have you taken prostate medication such as Finasteride (trade name) or Proscar and Propecia (generics)? They can have a similar side effect with smaller more aggressive cancers that can prove to be difficult to find (especially in enlarged prostates). It will also suppress your PSA levels by at least half while on the medication.

    "Prostate cancer warning: This drug belongs to a class of drugs that could increase your risk of a faster growing or irregular form of prostate cancer. Finasteride can cause a decrease in your prostate specific antigen (PSA) level. An increased level of this antigen has been associated with prostate cancer. If your PSA levels increase while on this medication, it may be a sign of prostate cancer."
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    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3
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    Old 01-05-2022, 11:50 AM   #22
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    Re: New Guy - Had MRI - Next up biopsy

    How many samples did they take? The standard array of 12 for a prostate your size is not enough, imo. Good luck. I hope they find it so you can move forward.
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    Born 1953; family w/PCa-grandfather, 3 brothers
    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2
    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3
    5-4-16 DaVinci RP, Path-65g, lymph nodes, seminal vesicles, capsule, margin all neg, upgraded to G3+4, Tumor vol 35%, +pT2c, No Incontinence-6mos, Erections-14 months
    7-9-21 PSA less than 0.02; zero club 5yrs

     
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    Old 01-05-2022, 11:32 PM   #23
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    Re: New Guy - Had MRI - Next up biopsy

    Some Info.
    From The Cleveland Clinic

    "What are the advantages of holmium laser enucleation of the prostate (HoLEP)?

    Use of HoLEP in many different parts of the world has shown it to be a safe and effective procedure. Although there are many types of BPH surgeries available, HoLEP offers a unique advantage in being able to remove a large amount of tissue without any incisions on the body, even in VERY LARGE PROSTATES, while decreasing the risk of bleeding and providing tissue for pathology (to look for cancer). This decreases the need for blood transfusions during surgery, minimizes the time of stay in the hospital to one or two days, and reduces the risk of needing repeat treatment."

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    Old 01-06-2022, 03:03 AM   #24
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    Re: New Guy - Had MRI - Next up biopsy

    Sounds like a good potential answer for non-cancer patients with very large prostates.

     
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    Old 01-06-2022, 03:27 PM   #25
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    Re: New Guy - Had MRI - Next up biopsy

    Quote:
    Originally Posted by Prostatefree View Post
    Have you taken prostate medication such as Finasteride (trade name) or Proscar and Propecia (generics)?
    Nope, but probably should have.

    Glad I didn't now.

    I believe he took 18 (at least) samples. That was his plan.

    I've started researching de-bulking procedures like HoLEP, thanks for the reference.

    I've become very well read on the research as to radiation and large prostate volumes, for EBRT in general, and specifically IMRT, SBRT, and Proton Therapy. Also for HDR. Contra-indicated in general for LDR. For the others, the general outlook is more acute and late stage bother, but in the long run it settles out same as the small prostate folks.

    Also seen some papers on the surgical complexities of working around a large prostate, which increase the challenge. So there's that too.

    Thanks gents.

     
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    Old 01-07-2022, 08:57 AM   #26
    CentralPaDude
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    Re: New Guy - Had MRI - Next up biopsy

    So following the biopsy the urine was clear by the afternoon of the next day, but was certainly entertaining up to that point with various things coming out.

    Tried the other system today, and my wife suggested it was the look and consistency of fish chum. Heh. No pain involved.

    Just sharing for the next guy who is getting a biopsy. Don't get freaked out.

     
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    Old 01-07-2022, 09:22 AM   #27
    Prostatefree
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    Re: New Guy - Had MRI - Next up biopsy

    Fyi, there can still be a stray clot or two show up, but as you said, don't freak out.
    __________________
    Born 1953; family w/PCa-grandfather, 3 brothers
    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2
    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3
    5-4-16 DaVinci RP, Path-65g, lymph nodes, seminal vesicles, capsule, margin all neg, upgraded to G3+4, Tumor vol 35%, +pT2c, No Incontinence-6mos, Erections-14 months
    7-9-21 PSA less than 0.02; zero club 5yrs

     
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    Old 01-08-2022, 04:10 PM   #28
    CentralPaDude
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    Re: New Guy - Had MRI - Next up biopsy

    So just got the biopsy results. 13 cores, 12 random and 1 aimed at my PIRADS 4 spot. The twelve random are benign (normal) tissue, the one targeted is

    13 Prostate, left apex periph zone P4, Needle Biopsy
    - Prostatic adenocarcinoma, Gleason score 3+3=6 (grade group 1).
    - Carcinoma involves 2 of 3 cores, linear extent 4 mm (70% of core) and 2 mm (15% of cores)

    From lower in report, I guess he took 3 targeted cores of the MRI lesson, as he said he would...

    13. Received in formalin, labeled with patient´s name and date of birth and `` targeted left apex peripheral zone pirad 4´´, are three white-gray, focally yellow soft tissue cores measuring from 0.9 up to 1.7 cm in length, and 0.1 cm in diameter. Entirely submitted. Block summary: 13A (JAK)

    Sounds as good as I hoped. Appreciate comments.

     
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    Old 01-09-2022, 04:45 AM   #29
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    Re: New Guy - Had MRI - Next up biopsy

    That is a relatively great biopsy report. While you do have prostate cancer, a Gleason 3+3 is NOT life threatening and cannot metastasize.

    With only two positive cores, and your favorable PSA, you should be a candidate for Active Surveillance.

     
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    Old 01-09-2022, 05:58 AM   #30
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    Re: New Guy - Had MRI - Next up biopsy

    If you want, you now have what you need to remove your prostate. Now the question becomes what is the best path forward for treating both your cancer and BPH.

    Is there a family history of prostate cancer? Are they other PC contributing factors; obesity; ethnicity; young age?

    After my biopsy, I had a large volume of G6. After surgery, it proved to be a large volume of G7. The point of this remark is these are all small pieces of a puzzle, not the whole picture.

    Keep doing what you are doing. You are getting good care.

     
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